So, as they say…

Some news

For all the progress we’ve made in this pandemic (and there is a lot)

We still have important work to do to protect Americans’ lives and well being

So when @POTUS asked me to serve, I was honored to have the opportunity

nytimes.com/2022/03/17/us/…
This President has spoken the truth about this virus

Has prioritized policies based on science and evidence

Americans are going back to work and school

And it is an honor to work under his leadership

One focused on the health and well-being of the American people
We are in so much of a better place with vaccines, diagnostics, increasingly, therapeutics, and much more

Much of this because of the superb leadership of Jeff Zients

Who has used the levers of the US government to make available these miracles of science to the American people
The pandemic has taken an enormous toll on us all

It has left millions of families with a hole in the fabric of their lives

It has caused so much suffering both directly from the virus and its effects on mental health, income, education losses, and much more
We are not done

We are very likely to see more surges of infections

We may see more variants

We can’t predict everything with certainty

But we have to prepare to protect the American people whatever Mother Nature throws at us
And we have to continue to lead in helping the rest of the world get vaccinated, protected

Both because a global pandemic demands a global solution – and because it’s the right thing to do

And restoring America’s moral leadership has been a critical part of the past 15 months
On a personal note

For a poor immigrant kid who left India not speaking a word of English

And found in America a nation willing to embrace me as one of her own

I am deeply honored for this chance to serve this country I love

And grateful to a President for the opportunity
So we have some work to do my friends

As much as I wish otherwise, the pandemic is not over

So let’s keep our eye on the ball

Prepare for surges and variants

Work to ensure that schools, work, and other places of gathering remain safe

Vaccinate the world
If we an do all of that, we can protect the health of the American people

While also demonstrating moral leadership on the global stage

This is not the job of one person or even just the government.

It is the job of all of us

And I’m excited to get started on my part

• • •

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More from @ashishkjha

Mar 3
With infections down more than 90% since highs just 6 weeks ago

It is tempting to decide the pandemic is over

It is not

During this upcoming lull of infections (and falling deaths),

It's time to prepare for whatever is next

So what to prepare for -- and how?

Thread
The two questions I get asked most often these days are:

1. Will we see future variant

Answer: I don't know. No one does. Reasonable to assume we will. Let's hope we don't

2. Will we see future surges

Answer: most likely yes. Hope not

But remember: hope isn't a strategy

2/n
So with possible future variants and surges

We should focus on the playbook:

1. Surveillance
2. Vaccinations
3. Testing
4. Ventilation/filtration
5. Masking
6. Therapeutics

Much of this is in today's White House plan

(disclosure: I, others have shared our ideas with them)
Read 10 tweets
Feb 26
For two months, I've said we're entering a new phase of the pandemic

A phase marked by a lot of population immunity, a more immune-evasive but less virulent virus

This new phase requires new metrics

My @nytopinion piece on the latest CDC metrics

nytimes.com/2022/02/25/opi…
Fundamentally, new CDC metrics get it right

Why?

Because cases no longer are the most important measure

For nearly 2 years, for every 1000 cases, you could reliably predict 50-80 would end up in the hospital and about 15 to 20 people would die

That was true in 2020. And 2021
That tight link between cases --> hospitalizations --> deaths was true for original strain

And for Alpha
And for Delta

But Omicron severed that link (mostly)

Now, if you told me there were a 1000 new cases

I can no longer tell how many will end up hospitalized or dead

3/n
Read 9 tweets
Feb 18
Nationally as infections return to pre-Omicron surge levels,

Two states I've tracked closely are California & Florida

They're both large with diverse populations, similar seasonality, different COVID approaches

So what can we learn from comparing them?

A few things

Thread
First, let's compare how they did on infections during Omicron surge

Strikingly similar (see graph)

Florida peaked earlier, California a bit later

Cumulatively, they had nearly identical infection rates

About 9.50% of Floridians got infected while 9.54% of Californians did
So at first blush, looks like their different COVID strategies did not end up mattering much

But, when we look at deaths,

A different, surprising pattern emerges

Cumulatively, Florida had 33% more deaths per capita than California during Omi surge

That's a lot

Why?

3/5
Read 6 tweets
Feb 16
As the Omicron surge of infections abates,

Its worth reflecting on few lessons we learned

Today, lets' discuss whether Omicron was indeed "milder"

Short answer? Yes it was

But it still caused a devastating loss of life

And that's a lesson for managing future waves

Thread
First, let's talk about how we might assess whether Omicron was "milder" than Delta

One way is to look at case fatality rate

Remember CFR is proportion of identified cases that end up dying

Throughout the pandemic, the CFR of of COVID in the US has been between 1.5% to 2.0%
CFR is usually 1.5% but rises to 2.0% during surges as hospitals fill

Meaning that as hospitals fill up, admission thresholds rises...and ability to care for sick people diminishes

Its bad to be sick during a COVID surge

So what happened to CFR over the past 2 months?
Read 10 tweets
Feb 10
Let's discuss a path forward for masks in schools

I've been a strong proponent of masking in schools

So as we enter a new phase

Do we need to keep masking for the foreseeable future

I don't think so

Should we ban masks in schools today?

No

Let's find a middle path

Thread
First, let's talk evidence

Do masks work to reduce transmission?

Absolutely

What about in kids?

The evidence is less strong but clearly, the weight of evidence says that masking also works in kids

Are there harms?

Not much evidence either way but there could be

2/n
So given the (imperfect) evidence

Masking in schools was important while two things were true:

There were no vaccines for kids

Large surge of infections in the community

Now, as we enter a new phase

Every school-age kid can be vaccinated

And infections are getting low

3/n
Read 10 tweets
Feb 6
Quick update on the state of the pandemic in the US

Nationally,

Infections are down 60%

Hospitalizations down about 30%

Deaths have largely plateaued at a very high 2500+ per day

Beneath the headlines, we see dropping infections in every part of the country
Here are the four largest states

Geographically, politically diverse with very different strategies and mitigation policies

Infections are down 50-80% across these states

And hospitalizations have turned the corner in each of these states

Deaths are starting to follow
In fact, based on analysis from @CovidActNow

Infections are falling in 47 states. And quickly

And in 3 states, they have plateaued

That's good

So what happens next?

Several things
Read 8 tweets

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